Early and late surgical treatment of complete rupture of the radial collateral ligament of the first metacarpophalangeal joint

Stability of the first metacarpophalangeal joint is important for daily activities. Rupture of the radial collateral ligament of the first metacarpophalangeal joint (RCL) is less common than rupture of the ulnar collateral ligament, but serious ruptures of the radial ligament are as debilitating as those of the ulnar ligament. Consistent guidelines for treatment of complete RCL rupture have not yet been established. We recommend 4 weeks of immobilization by two K-wires, followed by extensive hand therapy, as primary treatment of complete RCL rupture. As late treatment of complete RCL rupture, we recommend surgical repair using a bone anchor, 4 weeks of immobilization, and subsequent hand therapy. Two patients with a complete RCL rupture are presented. One was treated early and the other received treatment 2 months after injury. These two cases illustrate the methods of early and late treatment.